Abstract
OBJECTIVE: To determine the changes in body weight, body composition, and bone density in patients with spondyloarthropathy (SpA) receiving anti-tumor necrosis factor-alpha (TNF-alpha) treatment. METHODS: One hundred six patients with SpA (80 men, 26 women) aged 20-71 years were included in a 2-year prospective open study. Fifty-nine patients received infliximab (3 or 5 mg/kg/infusion each 6 or 8 weeks); and 47 patients received etanercept (25 mg twice a week) because of persistent active disease despite an optimal treatment, according to ASsessments in Ankylosing Spondylitis Working Group criteria. Body weight, total body composition (lean mass, fat mass), and spine and femoral bone mineral density (BMD; dual-energy x-ray absorptiometry) were measured at baseline and at 1 and 2 years. RESULTS: There was a significant increase in body weight after 1 year (2.2 +/- 3.9 kg, i.e., 3.4%; p < 0.0001) and 2 years (2.2 +/- 4.7 kg, 3.5%; p < 0.0001), mostly due to a significant gain in fat mass at 1 year (1.4 +/- 2.6 kg, 12.1%; p < 0.0001) and 2 years (1.5 +/- 3.1 kg, 14.5%, p < 0.0001). Gain in lean mass was also significant at 1 year (0.8 +/- 2.2 kg, 1.9%; p < 0.0001) and 2 years (0.9 +/- 2.5 kg, 2%; p < 0.0001). At 2 years, lumbar spine and femur BMD increased: +5.8 +/- 13% (p < 0.0001) and +2.26 +/- 4.5% (p = 0.001), respectively. CONCLUSION: This 2-year prospective study showed a significant increase in body weight at 1 year and 2 years, mostly due to a gain in fat mass and a significant increase in BMD, in patients with SpA receiving anti-TNF-alpha treatment.
In this issue
